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Wednesday, July 26, 2017

Senate Votes to Take up Obamacare Repeal House Bill for Debate

On July 25, 2017, members of the U.S. Senate voted 51-50 to open up the American Health Care Act (AHCA) for debate. Vice President Pence cast the deciding vote on this "Motion to Proceed". The AHCA is the bill to repeal and replace the Affordable Care Act (ACA) that passed in the House of Representatives on May 4, 2017.

As a result of the vote, the Senate will now begin debate on the AHCA - a series of proposed amendments will undoubtedly be part of this process. One such amendment already failed yesterday evening with nine Republicans joining all Democrats in opposing the amendment.

The Motion to Proceed is, in essence, just a vote to have a vote. There appear to be four possible outcomes:

1. The Senate passes the AHCA in the same form as passed by the House. In that case, the bill would go to the President for signature. This outcome seems unlikely at this point.

2. The Senate passes its own bill, either some form of the Better Care Reconciliation Act of 2017 (BCRA) or something entirely different. There have been recent talks of the Senate possibly passing a "skinny bill" which would only repeal the ACA employer mandate, the individual mandate and the medical device tax. If the Senate passes the BCRA or another bill, then that bill could go to the House. If the House passes the Senate bill in the same form as passed by the Senate then the bill would go to the President for signature.

3. The Senate passes a form of the BCRA or something entirely different. The House and Senate decide to send the AHCA and the Senate bill to a joint House/Senate conference committee where they would attempt to resolve any differences between the two bills. If they are successful, then the revised conference committee bill would need to go back to both the House and Senate for a vote before it could be signed by President Trump.

4. The Senate is unsuccessful in passing any type of bill. In that case, it would appear that any repeal of the ACA would, at the very least, be delayed. Remember, however, that "repeal and replace" has been pronounced dead on several prior occasions.